Risk Management in Healthcare | Case Study

• MIA JESSELENE SUGUITAN

Risk Management Process

Regency rest home and hospital provides assistive works for the day to day living most especially for the people who cannot manage to support their everyday routine. In identifying and characterizing the risk, this is assessing possible risk invaders in the organization and distinguishing possible reasons occurring in a workplace. Vulnerability affects the residents and employee work and its environment, it also tackles about currents assets involving establishments, equipment, appliances and financial status. It is also better to determine the effect or the impact of the said risk in the presence of the likelihood. In reducing possible risk, it is a best benefit in the part of employees and for the resident for the better provision in the future. Thus, this depends on the process of what the rest home and hospital measures every performance and its management styles.

Examples of management process;

1. Risk assessment process at Regency Rest Home and Hospital which includes (a)identifying and characterizing risk in the organization, (b)assessing vulnerability and assets to specific threats as scaled from 0%-100%,(c) determining the risk and the consequences in the likelihood,(d)different ways to reduce risk in the rest home and hospital,(e)prioritizing risk based on strategy.

Residential risk

a.1 Risk of fall and slips from the residents during the given shift.

• Scattered wires and adaptors inside the establishments.
• Side rails improperly laid up.
• Poor housekeeping on the equipment’s and appliances.

b. The health and safety of the employee and the residents would affect the day to day activities. This might likely arise about 20% within people vulnerability assets.

c. In the impact of likelihood this would affect the resident day to day activity and cannot able to help his/herself personal recreational stuffs.

d. To reduce risk there should be;

• Be proper housekeeping of appliances and equipment’s after used.
• After any activity done for a patient always remember when putting back on her bed most especially for aggressive residents, always put side rails up. And if rails are not available always put pillows on each side of the bed.
• Put up signage to prevent injuries.

e. Avoidance the risk of possible falls or slips and do something to avoid any accidents that would affect not only on the health and safety of the residents but also on the part of each employee.

a.2 Risk of improper handling and assisting care to the residents most particularly on their personal hygiene.

• Taking bath on residents that involves in washing their private parts.
• Tidying their wardrobe and room every after washed.

b.10% would possibly affect the residents personal rights on to her/his own needs in caring their body. Since some of the residents can still manage to clean their selves, we still need to supervise their activity and asked if they need assistance. Another is other residents cannot able to look up their personal regimens so, a full assistance is needed for them. This would also affect the reputation of the rest home and hospital if someone would report any malicious act as every activity is ongoing, example is when bathing and washing their private parts.

c. The impact of likelihood would be, since some of the residents experienced dementia (loss of ability to think properly especially on his/her daily routines) in rendering health care services unexplained procedures in residents, may feel unprotected and abuse in the site of their caregivers/health care assistance. And for other residents reputation from the care givers would probably ungreatful.

d. To reduce risk;

• Inform consent and explain any activity to be done.

• Respect resident privacy in carry out cares.
• Encourage resident to improve level of independence like in their personal hygiene and activities.
• Correct use of mobility aids or with the assistance from the fellow employee member.

e. Limit the risk in this situation because this is considered as a part of the daily activity wherein residents should always be seen nice and tidy every day. Making sure that every residents are respected and informed any procedures to be than on the course of any activity to prevent any faults.

Employee/staff member risk

a.3 Risk in Improper delegation of tasked on the course of assigned shift.

• Miss communication between staff and staff members in designating proper tasked.
• In coherent data assessment that would effect on the future needs of a residents.

b. 20% would affect staff members and not doing healthy in the career would be liable by negligence in the part or rendering care to residents.

c. The impact of risk in likelihood would be a negative and unhelpful outlook to each employee and colleagues. Also it affects the reputation of the institution itself to the other residents who wanted to be a part of the associate.

d. To ­­­­­­­­­reduce risk;

• Willingness to complete the tasked in time, given to each employee positive and helpful outlook toward every residents and colleagues
• Active discussion and problem solving for the members of the staff.
• Completes distributed tasked.
• Show consideration to the other colleagues and to the residents
• Ensures planned works can meet the needs of every resident
• Participate scheduled staff meetings and discussions.

e. Limit the possible result of miscommunication, if possible mingle and have knowledge on things with the members of staff and adjust with the team member and staff to minimize extent of risk.

Disaster risk

a.4 Risk in Fire inside the establishment especially on the assigned wing.

• Facilities, equipment and appliances are damage.
• Residents and employees of the establishment would experience injuries during any fire outbreak.

b. About 5% to be roughly to happen. Critical assets like the building, the equipment’s, appliances and scarcity of money would affect the health and safety of every resident and employee as well.

c. The impact of likelihood is fire would occur establishments would fall down into business, financial would affect the employee’s job and the lost properties.

d. To reduce risk;

• Have knowledge and understanding on the emergency situation especially on fire
• Reports any hazard and damages in the equipment used while on shift.
• Attendance to one fire exits
• Have knowledge in fire manual
• Have knowledge and responsibilities in fire alarm sound.
• Have knowledge in hazard reporting
• Have knowledge on how and where to report damage

e. Transfer in the risk, this would help residents from having any grievances and on the part of the employee’s health and safety of residents, their selves, is their first priority. There are ways in securing residents lives like transferring residents into a near facilities if accident may happen.

Prioritizing the Risk

• From highest to lowest prioritization.

1. Improper delegation of tasked during the assigned shift.

2. Risk from falls and slips during the shift.

3. Risk in handling and assisting residents on their personal routine

4. Risk from fire in the premises.

2. Risk management frameworks and The Principles

In risk management framework, it overviews goals, objectives, qualitative and quantitative parts of an organization.

COSO framework has been introduced and this was used by every business and management in dealing uncertain threats and risk than may encounter in a workplace. It defines as a process, where it affects the peoples entity applied in a setting to recognize possible risk to ensure achievement of a certain objectives most especially in the industry you are working for.

Entity objectives with its category;

• Strategic
• Operational
• Reporting
• Compliance

In event identification, it identifies risk and opportunities in a certain workplace. It may result into a negative or positive outlook of every people. Involves identifying those cases, like internally or externally, that could affect strategy and reaching the objectives that they want.it also talks how internal and external factors combine and interact to influence the management risk. For example;

Events from a disaster like fire, this is identified as a part of an event that would happen anytime or in the future and it needs a proper management caution if ever this will occur.

In risk assessment, allows an entity to recognize the extent to which latent events might impact objectives. Assesses risks from viewpoints or the perception in the impact of likelihood. Is used to assess risks and used to quantify the related objectives. For example;

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In events like fire, risk could cause burns from equipment, appliances and establishment. Also it affects the residents and the staff member as well. Abrasions, contusions and concussions would likely experienced, and unexpected events like this must have identify measures of management. Works a combination of both

qualitative and quantitative risk assessment organizations.

Risk response, measures the degree and cost of impact in a likelihood. And also it evaluates the possible response of an identified risk. In control activities, this is the application of general information to control possible risk or events that would occur. In information and communication this pertains the time frame of an employee on its works on how he/she carries out responsibilities. The most effective ERM component is the monitoring wherein there is a separate evaluations for each activity that has been done in a day.

Internal control and integrated framework includes objective setting as an isolated component. Objectives is a part of the qualification for internal control. It also expands the financial reporting and risk assessment.

The components of a risk management in a workplace is very helpful if risk occurs. Strategies in risk assessment would quantify the proportion of cause of a certain risk. The entity and division level, for as a healthcare assistance or caregivers has a big part on the residents lives more likely in assisting and rendering care for them.

3. Part of the risk management process within an organization. And examples of each step

a. Determine the objectives at Regency Rest home and hospital.

• To Support residents on the activities of the day to day that will reflects on the resident’s level of dependency.
• To actively promote and maintain environmental safety for the residents
• To provide a service to all residents that is considerate and professional
• To work effectively as a team member for the betterment of the work.
• To support every residents on their social need

For example, in every task that we do, we involve our patients/residencies independency, like tooth brushing, changing clothes and others. We provide support for all their care especially to those who can’t able to upkeep his/her self. The establishments has a variety of facilities wherein residents can join the fan like watching concerts in the lounge with their fellow residents.

b./c.Identify exposures to loss and the Measure exposures from the organization.

In determining loss, “threats” are the most consequence that results in a loss of some part of category of an organization.

Example of loss;

Financial– about 70-80% is the scale because the organization like the rest home and hospital depends on the net income. And the equipment, insurance compensation of every employee, re-furbish of the establishment and many more.

Liability– 20-30%this covers the defending claim of the residents to the employee on the management activities.

For example;

When caregivers forgets to put up side rails during or after care on bed, most especially if the residents is aggressive this will be known as Negligence to work.

Personal loss– 10-15% likely to happen like personal injury, real properties and personal property. Such as fire which could affect organization and the establishment as well.

Checklist and surveys can be a helpful in determining exposure to loss.

d.Select alternatives on the organization

Brainstorming, listening or noting of alternatives, is an outstanding discovery process. Once you have listed alternatives, be open to their opportunities.

For example;

When having an orientation to every staff members everyone is allowed to share comment and suggestions in relative to the topic they are discussing. And also data gathering like time of washing, if they had bowel or not and also in feeding resident, we make sure they are listed because this will help employee to make resolution if some of the activities are maintain.

e.Implement a solution at Regency Rest Home and Hospital

Risk management is a series of action composed or made-up of well-defined steps which when taken in order, support better decision making by contributing to a greater insight into risks and their impacts. By acquiring effective risk management there are techniques that can help improved safety and quality. As healthcare settings vary greatly in their day-to-day function, it is not possible to provide a one appropriate all approach to risk management.

At this stage all the information gained brought together to consider what actions should be taken. In order to make this process, consider how the level of risk will be affected by the planed alleviation strategies.

EXAMPLE:

• Avoiding the risk: avoiding risk to get become worst. Selecting other lower risk procedure.
• Reducing the risk: can be reduced through preventative measures, and perform the required task and minimize the risk.
• Transferring the risk: getting another individual or team to assist or perform that are better equipped or have more experience in doing the task.
• Retaining the risk and managing: strategies include using PPE (PERSONAL PROTECTIVE EQUIPMENT).

f. Monitor and review the outcomes of risk management.

Monitoring is very broad, it’s just not mean to check on what is happening overall. Monitoring can be useful enough for setting what is wrong and making good things to a better one. Monitoring is not just merely watching or observing because it will look like it was a passive monitoring. The best way to monitor things out in an organization is the combination of watching/observing with the aid of listening, because listening was the way of at least knowing the reaction of the people lower than the management and for those people whom you are giving your care. And employees are good basis of information. For example;

In giving or assisting residents in their personal regimen, residents may comment to their caregivers how appreciated they are helping them in performing their daily routine and as per observation by their fellow employee feedbacks will turn unto you and this will give a better chances either to renew a contact or not all.